Provider Demographics
NPI:1255478160
Name:MERCER, FRANK III (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:MERCER
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 RODNEY LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2227
Mailing Address - Country:US
Mailing Address - Phone:757-963-8868
Mailing Address - Fax:757-963-8867
Practice Address - Street 1:1401 TIDEWATER DR
Practice Address - Street 2:SUITE 1
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2840
Practice Address - Country:US
Practice Address - Phone:757-963-8868
Practice Address - Fax:757-963-8867
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000848213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009300066Medicaid
VA095891OtherBLUE CROSS BLUE SHIELD
VA480000665Medicare ID - Type UnspecifiedMEDICARE NUMBER
VAU17415Medicare UPIN